Successful resuscitation after ropivacaine and lidocaine-induced ventricular arrhythmia following posterior lumbar plexus block in a child

Anesth Analg. 2008 May;106(5):1572-4, table of contents. doi: 10.1213/01.ane.0000286176.55971.f0.

Abstract

We report the case of a 13-yr-old girl scheduled for knee surgery under general anesthesia and posterior lumbar plexus block. A ventricular arrhythmia developed 15 min after local anesthetic injection. A 20% lipid emulsion was successful in converting the ventricular arrhythmia to a sinus rhythm. This is consistent with previous reports suggesting that lipid emulsion is an effective emergency treatment of local anesthetic toxicity. We recommend the immediate availability of lipid emulsion along with other emergency therapeutics in operating rooms where local anesthetics are used.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Amides / adverse effects*
  • Amides / blood
  • Anesthetics, Local / adverse effects*
  • Anesthetics, Local / blood
  • Electrocardiography
  • Emergency Treatment
  • Fat Emulsions, Intravenous / therapeutic use*
  • Female
  • Humans
  • Lidocaine / adverse effects*
  • Lidocaine / blood
  • Lumbosacral Plexus*
  • Nerve Block*
  • Practice Guidelines as Topic
  • Resuscitation / methods*
  • Ropivacaine
  • Tachycardia, Ventricular / chemically induced
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / therapy*

Substances

  • Amides
  • Anesthetics, Local
  • Fat Emulsions, Intravenous
  • Ropivacaine
  • Lidocaine